BITSEAPhoneInstructions

OMB #: 0925-0593

OMB Expiration Date: 08/31/2014

Neuro-Psychosocial BITSEA™ Instructions: Telephone, Phase 2g

The National Children’s Study

BITSEA™ Instructions

Telephone Questionnaire

Thank you for agreeing to participate in the National Children’s Study (NCS) and completing the Brief Infant-Toddler Social and Emotional Assessment (BITSEA™). This telephone questionnaire will take about 10 minutes to complete. It includes questions about children’s social and emotional behavior. If you have more than one child in the NCS, the telephone interviewer will ask you about each child separately.

Your answers are important to us. We will keep everything that you tell us confidential.

Listed below are several points that you may find helpful in answering these questions:

• Please refer to the hardcopy questionnaire that you received in the mail recently. Information in the questionnaire will help you answer the questions.

• Please keep this questionnaire handy so you will have it available when an NCS staff member calls you on the phone to ask you about the child’s behavior.

• The BITSEA™ consists of items that describe children’s social and emotional behaviors.

• Listen to each item carefully and then choose the answer that best describes the child’s typical behaviors over the past MONTH (30 days).

• There are no right or wrong answers.

If you have any questions, please call the local contact number located on the last page.

Thank you for taking the time to complete this questionnaire!

For Office Use Only:

Instructions for returning the questionnaire to the Regional Operations Center (ROC):

{Local instructions inserted by ROC. If the visit is done by phone, the ROC will provide information about returning it to the ROC.}

Insert ROC contact information label here.

NEU BITSEA™ Instructions: Telephone, MDES 4.0, V2.0 1